It is possible to have too much breast cancer awarenessby Michael Baum / June 20, 1997 / Leave a comment
In November last year British women were subjected to a breast cancer awareness month. Breast cancer was everywhere in the media, from broadsheet newspapers to soap operas. It even featured on the London underground with huge advertisements warning women that 1 in 12 would develop breast cancer in the course of their life. I was unsure what this publicity was meant to achieve and, judging from discussions with colleagues, who are also cancer specialists, no one of high rank had been consulted on the campaign. Most of us share the view that there is too much breast cancer awareness and and what we need, to give us a break from the excess of inappropriate referrals to our clinics, is a breast cancer unawareness month.
To describe the risk of developing breast cancer as 1 in 12 of the population is true, yet unhelpful. The 1 in 12 applies to a cumulative risk for those women who live to the age of 85. The incidence of breast cancer under the age of 30 is extremely rare and yet it is these women who are bombarded by breast cancer awareness campaigns and, as a result, grossly overestimate their risk. The real risk for women between the ages of 30 and 50 is about 1 per 1,000 per year. Under the age of 30 breast cancer is so rare it should not feature in a woman’s worst nightmares. Between the ages of 50 and 70 the time during which mammographic screening is often recommended, the risk rises to about 2 per 1,000 per year, and about a third of all reported breast cancers occur in the 70-85 age group.
If a woman finds out that she has a risk of breast cancer which is twice the average she is entitled to assume that she has a 1 in 6 chance of dying of the disease within the foreseeable future. Yet if she is 30 years old, her real risk doubles to 2 per 1,000 per year, which might seem insignificant against the other risks of living in a modern society.
Women with a family history of the breast cancer genes are different. These women have a 50 per cent chance of inheriting the gene. The gene itself has an 80 per cent penetrance, so these women know that they have a 40 per cent chance of developing breast cancer before the age…